论文部分内容阅读
目的分析新生儿B族溶血链球菌(GBS)感染血清型分布与临床表现相关性以及抗生素敏感性情况。方法收集深圳市福田区妇幼保健院和深圳市人民医院新生儿科2008年1月至2014年8月收治的GBS感染病例,对GBS菌株送检培养,菌种鉴定采用VITEK系统(BioMerieux,法国)及常规生化试验方法。采用乳胶凝集试验对所获得的GBS菌株进行血清学分型,采用纸片扩散法对GBS进行药敏试验检测,分析新生儿GBS耐药情况。结果共在26例患儿标本中查出GBS菌株,此26株GBS菌主要分为4个血清型(Ⅰa、Ⅰb、Ⅲ、Ⅴ),其中Ⅲ型17株(65.4%),Ⅰa型3株(11.5%),Ⅰb型3株(11.5%),Ⅴ型1株(3.8%),不可分型(NT)2株(7.7%)。新生儿GBS感染肺炎、败血症、化脓性脑膜炎的主要血清型为Ⅲ型。早发型感染以肺炎、败血症为主,晚发型感染以肺炎、败血症合并化脓性脑膜炎为主。GBS对青霉素、氯霉素、头孢曲松、米诺环素、头孢吡肟,万古霉素、美罗培南100%敏感,对左氧氟沙星84.6%敏感,红霉素、克林霉素耐药率分别为84.6%、81.8%,对四环霉素均耐药。结论新生儿GBS感染的血清型以Ⅲ型为主,青霉素仍是GBS感染的首选药物,红霉素、克林霉素及四环霉素耐药率高。
Objective To analyze the relationship between serotype distribution and clinical manifestations of neonatal B streptococci (GBS) infection and the antibiotic sensitivity. Methods The cases of GBS infection were collected from Futian District Maternity and Child Care Hospital of Shenzhen City and Shenzhen People’s Hospital from January 2008 to August 2014. The strains of GBS were collected and tested. The strains were identified by VITEK system (BioMerieux, France) and Conventional biochemical test methods. GBS strains obtained by latex agglutination test serological typing, using the disk diffusion method of GBS susceptibility testing to detect neonatal GBS resistance. Results A total of 26 strains of GBS were detected in the specimens of children with GBS. The 26 strains of GBS were divided into four serotypes (Ⅰa, Ⅰb, Ⅲ and Ⅴ), of which 17 were type Ⅲ (65.4%), 3 were type Ⅰa (11.5%), 3 strains of type Ib (11.5%), 1 strain of type V (3.8%) and 2 strains of un-typeable (NT) (7.7%). Neonatal GBS infection pneumonia, sepsis, purulent meningitis, the main serotypes of type Ⅲ. Early onset infection with pneumonia, sepsis-based, late-onset infection with pneumonia, sepsis with purulent meningitis. GBS was 100% sensitive to penicillin, chloramphenicol, ceftriaxone, minocycline, cefepime, vancomycin and meropenem, sensitive to 84.6% of levofloxacin. The rates of erythromycin and clindamycin were 84.6% and 81.8%, respectively, were resistant to tetracycline. Conclusion The serotypes of neonates with GBS infection are mainly type Ⅲ. Penicillin is still the drug of choice for GBS infection. The rates of erythromycin, clindamycin and tetracycline are high.